Case 2: Intergluteal Sulcus Flattening in a Newborn

Presentation

A 2,700-g female infant born at 40 weeks' gestation to a 26-year-old woman (gravida 1 para 1) is brought to the NICU with respiratory distress. While the infant is being treated for transient tachypnea of the newborn, the attending nurse notices that the sacral region does not appear normal and calls for the physician (Fig 1). The physician’s assistant agrees and orders ultrasonography for a possible diagnosis of vertebral fusion defect. Ultrasonography reveals a cystic mass extending into the abdomen. The neonatologist is consulted. Physical examination reveals a small nontender bulging mass, which has a rubberlike sensation on palpation at the sacral region. Abdominal magnetic resonance imaging confirms that the cystic mass is approximately 8,5 × 5,5 × 4 cm in size and is located behind the bladder in the pelvis (Fig 2, Video). Neurologic examination findings are completely normal, she shows no signs of sepsis, and her laboratory values are unremarkable.